Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA

Özer, Füsun Demirçivi; Duransoy, Yusuf Kurtuluş; Çamlar, Mahmut

doi:10.1007/s00701-009-0367-5

Cited by 18 publications

(15 citation statements)

References 4 publications

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“…5,9 The most common arteries reported are the AICA and the PICA. 6,12,14 In these case reports, MVD of the NI without sectioning was sufficient to produce pain relief. 10,11,17 Anatomically, NVC is most likely to occur proximally near the brainstem.…”

Section: Figmentioning

confidence: 75%

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Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: a single-institution review

Holste

Hardaway

Raslan³

et al. 2019

Journal of Neurosurgery

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OBJECTIVE Nervus intermedius neuralgia (NIN) or geniculate neuralgia is a rare facial pain condition consisting of sharp, lancinating pain deep in the ear and can occur alongside trigeminal neuralgia (TN). Studies on the clinical presentation, intraoperative findings, and ultimately postoperative outcomes are extremely limited. The aim of this study was to examine the clinical presentation and surgical findings, and determine pain-free survival after sectioning of the nervus intermedius (NI). METHODS The authors conducted a retrospective chart review and survey of patients who were diagnosed with NIN at one institution and who underwent neurosurgical interventions. Pain-free survival was determined through chart review and phone interviews using a modified facial pain and quality of life questionnaire and represented as Kaplan-Meier curves. RESULTS The authors found 15 patients with NIN who underwent microsurgical intervention performed by two surgeons from 2002 to 2016 at a single institution. Fourteen of these patients underwent sectioning of the NI, and 8 of 14 had concomitant TN. Five patients had visible neurovascular compression (NVC) of the NI by the anterior inferior cerebellar artery in most cases where NVC was found. The most common postoperative complaints were dizziness and vertigo, diplopia, ear fullness, tinnitus, and temporary facial nerve palsy. Thirteen of the 14 patients reportedly experienced pain relief immediately after surgery. The mean length of follow-up was 6.41 years (range 8 months to 14.5 years). Overall recurrence of any pain was 42% (6 of 14), and 4 patients (isolated NIN that received NI sectioning alone) reported their pain was the same or worse than before surgery at longest follow-up. The median pain-free survival was 4.82 years ± 14.85 months. The median pain-controlled survival was 6.22 years ± 15.78 months. CONCLUSIONS In this retrospective review, sectioning of the NI produced no major complications, such as permanent facial weakness or deafness, and was effective for patients when performed in addition to other procedures. After sectioning of the NI, patients experienced 4.8 years pain free and experienced 6.2 years of less pain than before surgery. Alone, sectioning of the NI was not effective. The pathophysiology of NIN is not entirely understood. It appears that neurovascular compression plays only a minor role in the syndrome and there is a high degree of overlap with TN.

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Section: Figmentioning

confidence: 75%

“…There is no quintessential culprit artery causing compression of the nerve, although a number of cases of neurovascular compression (NVC) of the NI by the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) have been reported. 2,3,6,9,11,17 In the remainder of cases, the vast majority, the etiology is unknown.…”

mentioning

confidence: 99%

Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: a single-institution review

Holste

Hardaway

Raslan³

et al. 2019

Journal of Neurosurgery

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“…Sakas et al, 9 Bellotti et al, 10 Younes et al 11 and Ozer et al 12 reported similar cases of geniculate neuralgia with suspected compression of nervus intermedius by the anterior inferior cerebellar artery. All patients underwent microvascular decompression of the compressed nervus intermedius, with long-term resolution of pain.…”

Section: Surgerymentioning

confidence: 92%

“…Therefore, 18 papers were included in the review. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] All reports directly related to geniculate neuralgia were classified as level 4 evidence, consisting of single case reports or small case series. There were two level 1 systematic reviews, which discussed the medical therapy of neuralgia.…”

Section: Methodsmentioning

confidence: 99%

Geniculate neuralgia: a systematic review

et al. 2014

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“…The main advantage of this non-destructive treatment option is a lower risk of sensory deficits in the nervus intermedius domain, although, also in MVD alone, neurological deficits such as transient facial nerve palsy or partial hearing loss have been observed [5,12,14] . The main limitation in those cases reported in the literature as well as in the present case is the relatively short time of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Microvascular Decompression of the Anterior Inferior Cerebellar Artery for Intermediate Nerve Neuralgia

Younes

Capelle

Krauss

2010

Stereotact Funct Neurosurg

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The authors present the case of a 63-year-old woman with a 5-year history of intractable paroxysmal ‘atypical’ otofacial pain. The patient’s pain attacks were not typical for either trigeminal or vagoglossopharyngeal neuralgia. Surgical exploration via a suboccipital retromastoid craniotomy showed vascular compression of the nervus intermedius by the anterior inferior cerebellar artery and the patient’s pain was successfully managed with microvascular decompression.

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Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA

Cited by 18 publications

References 4 publications

Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: a single-institution review

Pain-free and pain-controlled survival after sectioning the nervus intermedius in nervus intermedius neuralgia: a single-institution review

Geniculate neuralgia: a systematic review

Microvascular Decompression of the Anterior Inferior Cerebellar Artery for Intermediate Nerve Neuralgia

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